Transvaginal Bladder Neck Suspension

WHAT YOU SHOULD KNOW:

Transvaginal bladder neck suspension is surgery to treat stress incontinence (in-KON-tih-nence). Stress incontinence is when urine leaks with straining. This may happen when you are lifting heavy items, coughing, sneezing, or laughing. Transvaginal means that the surgery is done through your vagina (birth canal). The goal of surgery is to move the bladder and urethra back into their correct positions. Doing this may correct stress incontinence. The bladder is the organ that holds urine before it leaves the body. The urethra is the tube that carries urine from your bladder to the outside of your body.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

• There are always risks with surgery. You may bleed more than usual, get a urinary tract or wound infection, have trouble breathing, or get blood clots. The surgery could block the outlet of your bladder causing irritation and trouble urinating. A fistula (abnormal path) could develop, causing urine to stay in your body, instead of going out your urethra. Your caregivers will watch you closely for these problems and work to prevent or treat them.
  
  
• If you do not have surgery, your incontinence could get worse. Call your caregiver if you are worried or have questions about your medicine or care.

GETTING READY:

The Week Before Surgery:

• Ask your caregiver if you need to stop taking aspirin or any other blood thinning medicines before your procedure.
  
  
• Ask your caregiver before taking any over-the-counter medicine, such as laxatives, herbs, food supplements, or herb teas.
  
  
• You may need blood tests before your procedure. Talk to your caregiver about these or other tests you may need. Write down the date, time and location for each test.
  
  
• If caregivers think you may need a blood transfusion during surgery, you may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than several days before surgery. You may also ask a family member or friend with the same blood type to donate their blood. This is called directed blood donation. Talk to your caregiver for more information on autologous or directed blood donation.

The Night Before Surgery:

• You may be given a pill to take to help you sleep.
  
  
• Ask caregivers about directions for eating and drinking.

The Day of Surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• Ask your caregiver before taking any medicine on the day of surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of your medicines or the pill bottles with you to the hospital.
  
  
• Do not wear contact lenses the day of surgery. You may wear your glasses.
  
  
• If you are staying in the hospital after surgery, bring your personal belongings (bathrobe, toothbrush, hairbrush) with you. Do not wear jewelry or bring money to the hospital.
  
  
• An anesthesiologist may talk to you before your surgery. This is the caregiver who gives you medicine to make you sleepy during surgery.

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

TREATMENT:

What Will Happen:

• You will be asked to change into a hospital gown. You may be given medicine in your IV to help you relax or make you drowsy. You will be taken on a cart to the operating room. You may get medicine called regional anesthesia (an-iss-THEE-zuh) that will numb you below the waist. You may get general anesthesia to keep you completely asleep. You and your caregiver will decide which type is best for you.
  
  
• An incision is made in your vagina. A second incision is made in your lower abdomen (belly). Stitches (thread) are put in the tissue around your bladder to hold it up against your abdominal wall. This will help prevent urine from leaking when you strain.

After Surgery: You will be taken to a recovery room. You will be watched closely until you wake up. Feeling will return to the surgery area. You will then be taken to your room. A bandage will cover the stitches on your abdomen. You may have packing (bandages) inside your vagina and have a pad placed between your legs. Do not get out of bed until your caregiver says it is OK.

Waiting Room: This is a room where your family can wait until you are ready for visitors after surgery. Your doctor or nurse will find them in this room to let them know how the surgery went. If your family leaves the hospital, ask them to leave a phone number where they can be reached. When it is time for you to go home after your surgery, someone will need to drive you home. Do not drive home alone. An adult should stay with you for at least 24 hours after surgery

CONTACT A CAREGIVER IF:

• You cannot make it to your surgery appointment on time.
  
  
• You have questions or concerns about your surgery.
  
  
• You have a fever (increased body temperature).
  
  
• The problems for which you are having surgery get worse.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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